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CVS ALBANY, L.L.C.
CHC12866-01 BEACON CHRISTIAN COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
BEACON CHRISTIAN COMMUNITY HEALTH CENTER
Subdivision Name
BCCHC - Annex
Type
HRSA-Funded Health Center
340B ID
CHC12866-01
Entity Address
2031 Forest Ave
Staten Island, NY 10303-1796
Grant Number
H80CS12866
Participating Start Date
7/1/2016
Last Recertification Date
3/12/2025
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06053
2045 FOREST AVE.
STATEN ISLAND, NY 10303
Pharmacy Comments
Contract Details
Approval Date
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David H. Kim, CEO
(718) 815-6560 Ext: 200
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/17/2017
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